Epilepsy: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Epilepsy?
A neurologist, a doctor who treats brain and nerve conditions, usually diagnoses and treats epilepsy. Children are often seen by a pediatric neurologist, a brain and nerve doctor for children. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is epilepsy?
Epilepsy is a brain disorder that causes repeated seizures. A seizure is a change in normal brain activity that lasts from a few seconds to a few minutes. Seizures happen when groups of nerve cells in the brain, called neurons, send the wrong signals.
There are many types of epilepsy and seizures. Anyone can develop it, at any age.
Symptoms
The signs of a seizure depend on the type of seizure. Many people picture someone falling down, shaking, and losing awareness. That is one kind of seizure, but it is not the most common. More often, a person having a seizure may:
- Seem confused.
- Stare into space.
- Wander.
- Make unusual movements.
- Be unable to answer questions.
Some people have an aura, an unusual feeling that warns a seizure is coming. After a seizure, some people feel tired, sleepy, weak, or confused. This can last from minutes to hours.
Causes and who gets it
Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many people, the cause is never found.
Known causes include a stroke, a brain tumor, a head injury, and gene changes. Infections of the brain, such as meningitis, can also lead to epilepsy. Some types run in families. In other people, a gene change happens with no family history.
Triggers do not cause epilepsy. They can set off a seizure in a person who already has it. Triggers include stress, drinking alcohol, missed meals, lack of sleep, and flashing lights.
How doctors diagnose it
Epilepsy is generally diagnosed after a person has had two or more unprovoked seizures. These seizures are at least 24 hours apart.
The doctor first asks about the seizures and your health history. People often do not remember a seizure, so accounts from witnesses are very important. Tests may include:
- An EEG (electroencephalogram), a test that measures electrical activity in the brain.
- A CT or MRI scan, which are pictures of the brain that can show problems such as tumors and cysts.
- Blood tests, which can check for infections, lead poisoning, anemia, and diabetes that may cause or trigger seizures.
Treatment
Treatment should begin as soon as possible after diagnosis. There is no cure for epilepsy, but medicines can control seizures for most people.
The most common treatment is antiseizure medicine. Most seizures can be controlled with one drug. It may take several months to find the best medicine. If one does not work, another may work better.
Never stop seizure medicine on your own. Follow your doctor's instructions. Stopping too early is a major reason people who were seizure-free start having seizures again. It can lead to status epilepticus, a long seizure that can be life threatening.
Other options can help when medicine does not work well:
- Surgery is usually only considered after at least two medicines have not worked, or when doctors find an area of abnormal brain tissue believed to cause the seizures. Surgery can reduce or even stop seizures for many people. It can also cause changes in thinking or personality, or physical disability.
- Vagus nerve stimulation uses a device placed under the skin of the chest. It sends short bursts of electrical energy to the brain.
- A ketogenic diet is a high-fat, very low carbohydrate diet. It reduces seizures for some people, especially children, with certain forms of epilepsy. It can lead to kidney stones, so a doctor or nutritionist should help.
When to see a doctor
Tell your doctor when you have a seizure, whatever the type. Having one seizure does not by itself mean you have epilepsy.
Call 911 or go to the emergency room if a seizure lasts longer than five minutes, or if the person does not fully wake up between seizures. Also call 911 if the person has trouble breathing or a head injury or other serious injury during a seizure. A long seizure or seizures that repeat without waking can be signs of status epilepticus, which can be life threatening and needs medical care right away.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review your seizure history, order first tests, and refer you to a neurologist.
Common questions
Can epilepsy be cured?
No, there is no cure for epilepsy, but medicines can control seizures for most people. When medicines do not work well, surgery, implanted devices, or special diets may help.
Does one seizure mean I have epilepsy?
No, having one seizure does not by itself mean a person has epilepsy. A child with a high fever can have a seizure, for example. Epilepsy is generally diagnosed after two or more unprovoked seizures at least 24 hours apart. Tell your doctor about any seizure.
Can people with epilepsy live a normal life?
Yes, many people with epilepsy can live a full life.
What can trigger a seizure?
Common triggers include stress, alcohol, missed meals, dehydration, lack of sleep, and flashing lights. Triggers do not cause epilepsy, but they can spark a seizure in people who are prone to them.
Sources
- MedlinePlus - Epilepsy
- National Institute of Neurological Disorders and Stroke - Epilepsy and Seizures
- Centers for Disease Control and Prevention - Epilepsy Basics
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
